Comparison of Intravascular Ultrasound and X-ray Computed Tomography of the Thoracic Aorta: Correlation with Ischemic Heart Disease and Risk Factors |
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Authors: | Eiji Tamiya Hiroyasu Ando Nobuhiko Ito Hiroshi Ikenouchi Yoshiyuki Hada |
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Institution: | (1) Department of Cardiology, JR Tokyo General Hospital, Tokyo, Japan, JP |
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Abstract: | To compare plaque and calcification of the thoracic aorta with ischemic heart disease and risk factors, the authors used intravascular
ultrasound (IVUS) and X-ray computed tomography (CT). The study included 29 patients (24 males and 5 females, mean age 61
± 11 years): 21 with ischemic heart disease (IHD) and 8 with valvular disease or dilated cardiomyopathy. A Sonicath Ultra
6 imaging catheter (12.5 MHz, Scimed) was inserted through the femoral artery, and IVUS images were obtained around the descending
aorta at the level of the pulmonary artery bifurcation. Percent plaque area (%PA) was calculated as vessel cross sectional
area (CSA) surrounded by media minus lumen CSA divided by vessel CSA. The CVIS clear view system (Scimed) was used for image
analysis. CT without contrast enhancement was performed from the aortic arch to the diaphragm in horizontal sections of 1
cm. The number of slices showing aortic calcification was determined as the CT calcification score. Coronary angiography (CAG)
was also performed in each patient, and the authors analyzed the correlation of these imaging modalities with IHD with multiple
risk factors. In the descending aorta the IVUS probe was not eccentric and gave accurate images of plaque. In the ascending
aorta or aortic arch, the probe was somewhat eccentric. Plaque was observed to be diffuse without discrete lesions. The %PA
was 2.5–28.6 (14.9 ± 5.5) %, and the CT score was 0–25 (8.2 ± 7.9). The %PA and CT score showed a significant correlation
with each other (r = 0.57, p <0.05) and with age (r = 0.44 and 0.64, respectively, p <0.05). Neither showed a significant
correlation with findings from CAG or risk factors. IVUS accurately detects the presence and extent of plaque in the thoracic
aorta. The %PA shows a significant correlation with CT-detected calcification of the aorta. Neither calcification nor plaque
is correlated with IHD or risk factors. IVUS-detected plaque and CT-detected calcification are strongly influenced by age. |
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